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Sex differences in sleep and psychological disturbances among patients admitted for cardiovascular diseases

  • Sleep Breathing Physiology and Disorders • Original Article
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Abstract

Background

Understanding sex differences is critical for improving outcomes in patients with cardiovascular conditions. Sleep and psychological disturbances contribute to the development and progression of cardiovascular diseases, and important sex differences persist in their incidence and association with clinical outcomes.

Methods

Sex-based variation in sleep and psychological disturbances were assessed in consecutive patients with cardiovascular diseases in a single university hospital. The prevalence of insomnia, sleep disordered breathing (SDB), anxiety, and depression was assessed using the Pittsburgh Sleep Quality Index (PSQI), nocturnal pulse oximeter, and the Hospital Anxiety and Depression Scale (HADS). The effect of sex on the prevalence of sleep and psychological disturbances as well as their associations was quantified using multivariate logistic regression models.

Results

Among 1,233 patients (mean age 63.6 years, 25% women), women were significantly less likely than men to experience SDB (17.5% vs 31.5%, p < 0.001), but more likely to report an increased burden of insomnia (54.7% vs 43.3%, p = 0.001) and depression (23.9% vs 16.7%, p = 0.004). Insomnia was associated with depression, which was more remarkable among women (p value for interaction: 0.039). SDB was associated with anxiety among women but not men (p value for interaction: 0.003). There was no significant difference in the prevalence of anxiety between women and men.

Conclusions

Among patients with cardiovascular disease, women reported an increased burden of insomnia and depression compared to men. The association between sleep and psychological disturbances may be more pronounced in women, suggesting that cardiologists should increase efforts for identification of such comorbidities and administer corresponding treatment, especially in women.

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Acknowledgements

The authors would like to thank all the study patients for their time and effort, as well as the nurses and staff for their role in data capture.

Funding

This study was funded by Grant-in-Aid for Scientific Research (17K09526 and 18H03087).

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Yuichi Jono, Takashi Kohno, Shun Kohsaka, Hiroki Kitakata, Yasuyuki Shiraishi, Kentaro Hayashida, Shinsuke Yuasa, Seiji Takatsuki & Keiichi Fukuda

  2. Department of Cardiovascular Medicine, Faculty of Medicine, Kyorin University, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan

    Takashi Kohno

  3. Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan

    Yoshinori Katsumata

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  1. Yuichi Jono
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Correspondence to Takashi Kohno.

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Jono, Y., Kohno, T., Kohsaka, S. et al. Sex differences in sleep and psychological disturbances among patients admitted for cardiovascular diseases. Sleep Breath 26, 1–9 (2022). https://doi.org/10.1007/s11325-021-02544-4

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  • DOI: https://doi.org/10.1007/s11325-021-02544-4

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